HCPCS Level II modifier
Modifier EP
Modifier EP is a HCPCS Level II modifier. CMS describes it as: Service provided as part of medicaid early periodic screening diagnosis and treatment (EPSDT) program.
Source: CMS HCPCS Level II, October 2026 file dated September 23, 2026. Publisher page
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- Modifier
- EP
- Type
- HCPCS Level II modifier, maintained by CMS
- CMS description
- Service provided as part of medicaid early periodic screening diagnosis and treatment (EPSDT) program
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
- Guidance
- CMS HCPCS quarterly update
Related modifiers
- ERItems and services furnished by a provider-based, off-campus emergency department
- EMEmergency reserve supply (for ESRD benefit only)
- ETEmergency services
- EJSubsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab
- EXExpatriate beneficiary
- EEHematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
- EYNo physician or other licensed health care provider order for this item or service
- EDHematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle
Related pages
Questions
What does modifier EP mean?
Modifier EP is a HCPCS Level II modifier. CMS describes it as: Service provided as part of medicaid early periodic screening diagnosis and treatment (EPSDT) program.
Is modifier EP a CPT or a HCPCS modifier?
EP is a HCPCS Level II modifier from the CMS quarterly HCPCS file. Two-digit numeric modifiers, such as 25 or 59, are CPT modifiers.
Where does modifier EP go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.